A radical ketamine-like drug has been licensed for use in the UK for severe depression, a decision that offers hope to the millions of patients for whom conventional treatments have failed. The Guardian reports that Esketamine, taken as a nasal spray, is one of the first rapid-acting drugs for depression and the first in decades that is thought to work in a fundamentally different way in the brain. However, psychiatrists are divided on the benefits, with some hailing esketamine as a game-changer and others raising fears about the potential for addiction and abuse.
Before the drug can be marketed in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) must decide whether it will impose any additional safety requirements, such as patients being monitored for longer periods or the introduction of a registry.
According to the report, John Read, a professor of clinical psychology at the University of East London, who was among the critics, said: “The fear is that in a few years we will be having a Public Health England review into people who can’t get off esketamine. At this stage we really should be cautious.”
Professor Allan Young, the director of the Centre for Affective Disorders at King’s College London, who was involved in trials of esketamine, said: “All of the worries about the treatment causing psychosis or cravings, we didn’t see that in the data. It’s a very different scenario from the abuse scenario where people take massive doses. At the moment, safety looks good.”
Professor Rupert McShane, a consultant psychiatrist and associate professor at Oxford University, said he was disappointed that the European licence had not imposed a requirement for patients taking esketamine to be entered into a central registry that would enable the long-term outcomes to be tracked.
[link url="https://www.theguardian.com/science/2019/dec/19/ketamine-like-drug-depression-uk-licence-esketamine"]The Guardian report[/link]